A randomised controlled trial of VSL#3 for the prevention of endoscopic recurrence following surgery for Crohn's disease

ISRCTN ISRCTN67919733
DOI https://doi.org/10.1186/ISRCTN67919733
ClinicalTrials.gov number NCT00175292
Secondary identifying numbers UCT-52194
Submission date
18/11/2005
Registration date
18/11/2005
Last edited
11/04/2019
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Digestive System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Contact information

Dr Richard Neil Fedorak
Scientific

Director
Division of Gastroenterology
University of Alberta
Suite 205 College Plaza
8215 - 112 Street
Edmonton
T6G 2C8
Canada

Study information

Study designRandomised controlled trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Scientific titleA randomised controlled trial of VSL#3 for the prevention of endoscopic recurrence following surgery for Crohn's disease
Study objectivesTo determine the efficacy of the probiotic VSL#3 in the prevention of Crohn’s disease development following surgical resection and re-anastomosis.
Ethics approval(s)The Health Research Ethics Board (Biomedical Panel) of the University of Alberta, Edmonton, Alberta, gave approval on the 22nd June 2001
Health condition(s) or problem(s) studiedCrohn’s Disease/Inflammatory Bowel Disease
InterventionA randomised controlled trial of VSL#3 versus placebo

Trial details received 12 Sept 2005
Intervention typeOther
Primary outcome measureTo assess the efficacy of VSL#3 for the prevention of severe endoscopic recurrence (Rutgeerts Grade three or four) of Crohn’s disease, within 90 days of study treatment, in patients who have undergone an ileocolonic resection with small intestine to colonic anastomosis
Secondary outcome measures1. To assess the efficacy of VSL#3 to prevent all endoscopic recurrence of Crohn’s disease (Rutgeerts Grades one to four) within 90 days of study treatment
2. Determine the proportion of patients who require medical therapy for management of recurrent Crohn’s disease within 90 days of study treatment
3. To compare the time to severe endoscopic recurrence of Crohn’s disease (Rutgeerts endoscopic grade three or grade four) in subjects who receive immediate (within 30 days post resection) versus delayed (more than 90 days post resection) introduction of VSL#3 as maintenance therapy
4. To determine the proportion of patients who require medical therapy for management of their recurrent Crohn’s disease within 365 days of study treatment
5. To compare the treatments for overall Crohn’s disease activity as measured by the Crohn’s disease activity index (CDAI)
6. To compare the treatment for disease specific quality of life endpoints as measured by the inflammatory bowel disease questionnaire (IBDQ)
7. To assess the safety and tolerance of VSL#3
8. To determine:
8.1. The quantity and type of bacterial colonisation
8.2. Mucosal cytokine levels
8.3. Histologic injury
8.4. Mucosal metalloproteinase activity at the neo-terminal ileum and serum cytokine genotyping

These studies will be conducted at a subset of participating centres in Canada.
Overall study start date01/01/2002
Completion date31/12/2012

Eligibility

Participant type(s)Patient
Age groupAdult
SexBoth
Target number of participants120
Key inclusion criteria1. Subjects who are 16 years of age or older
2. Have a diagnosis of Crohn’s disease of at least three months’ duration, prior to ileocolonic resection, and the diagnosis is confirmed by radiological studies or endoscopy with biopsy or surgical pathology
3. Resection of ileocolonic Crohn’s disease, with margins macroscopically free of disease, and small bowel to colonic anastomosis no more than 30 days prior to randomisation
4. Females of child-bearing potential (have not had tubal ligation, hysterectomy or other surgical procedure for sterilisation) must have a negative urine or serum pregnancy test within one week of entry into the study and agree to use an acceptable method for contraception throughout the trial. Acceptable methods of contraception include oral contraceptives, implantable contraceptives, injectable contraceptives, intrauterine device or barrier methods (diaphragm with spermicidal gel plus condoms, condoms with contraceptive sponges, condom plus intravaginal suppository).
5. Voluntarily able to provide informed written consent
Key exclusion criteria1. Use of other medications for the treatment of Crohn’s disease following surgical resection (perioperative steroids in tapering doses and antidiarrhoeal agents - codeine, loperamide, diphenoxylate or cholestyramine are acceptable)
2. Treatment with a tumour necrotising factor (TNF)-antagonist in the eight weeks prior to resection
3. Clinically significant Crohn’s disease elsewhere in the gastrointestinal tract
4. Clinically documented short bowel syndrome (greater than 100 cm of small bowel resected)
5. Serious underlying disease other than Crohn’s disease
6. Significantly impaired liver or renal function
7. History of cancer with less than two years in a documented disease-free state (other than resected cutaneous basal and squamous cell carcinoma and or in situ cervical cancer)
8. Patients with the following laboratory abnormalities:
8.1. White blood count less than 3 x 10^9/l
8.2. Lymphocyte count less than 0.5 x 10^9/l
8.3. Haemoglobin less than 80 g/dl
8.4. Platelet count less than 125 x 10^9/l or more than 800 x 10^9/l
8.5. Alanine aminotransferase (ALT) or aspartate aminotransferase (AST) more than 2.0 times the upper limit of normal
8.6. Alkaline phosphatase more than 2.0 times the upper limit of normal
8.7. Serum Creatinine more than 1.5 times the upper limit of normal
9. Patients using ethanol or consuming illicit drugs which, in the investigators opinion, may interfere with compliance with the study procedures
10. Patients with active psychiatric problems, which, in the investigators opinion, may interfere with compliance with the study procedures
11. Patients using concomitant investigational therapy
12. Patients who are unable to attend study visits or comply with study procedures
Date of first enrolment01/01/2002
Date of final enrolment31/12/2012

Locations

Countries of recruitment

  • Canada

Study participating centre

Director
Edmonton
T6G 2C8
Canada

Sponsor information

University of Alberta (Canada)
University/education

1A University Campus N.W.
1-05 Assinaboia Hall
Edmonton
T6G 2E1
Canada

Website http://www.ualberta.ca/
ROR logo "ROR" https://ror.org/0160cpw27

Funders

Funder type

Research organisation

Canadian Institutes of Health Research (ref: UCT-52194)
Government organisation / National government
Alternative name(s)
Instituts de Recherche en Santé du Canada, Canadian Institutes of Health Research (CIHR), CIHR_IRSC, Canadian Institutes of Health Research | Ottawa ON, CIHR, IRSC
Location
Canada

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Results article results 01/05/2015 19/02/2019 Yes No

Editorial Notes

11/04/2019: Internal review.
19/02/2019: Publication reference added.
21/01/2019: Contact details updated.